Kratom health risks

Health Canada is warning Canadians about the risks of using kratom (Mitragyna speciosa), a plant native to Southeast Asia that is widely available on the internet and often sold in the form of a pill, capsule, powder or tea (leaves). Kratom is known to be sold with unproven claims for the treatment of opioid addiction and withdrawal as well as for treating high blood pressure, cancer and other serious medical conditions. Kratom can cause similar effects to both narcotics and stimulants and has similar risks of abuse and addiction. A number of deaths in the United States have been associated with the use of kratom in combination with illicit drugs. Kratom leaves contain the compounds mitragynine and 7-a-hydroxymitragynine which are responsible for the narcotic and stimulant-like effects that users may experience when they consume it.

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Health risks associated with kratom

Kratom goes by different names such as:

  • Biak
  • Ketum Kakuam
  • Ithang
  • Thom
  • Mitragynine extract
  • Cratom
  • Gratom
  • Kakuam
  • Katawn
  • Kedemba
  • Ketum
  • Krathom
  • Krton
  • Mambog
  • Madat
  • Maeng da leaf
  • Nauclea
  • Nauclea speciose
  • Thang

There are a number of side effects associated with kratom which may include:

  • Liver damage
  • Nausea
  • Itching
  • Sweating
  • Dry mouth
  • Seizure
  • Constipation
  • Increased urination
  • Loss of appetite
  • Hallucinations

Although it has not been directly implicated in deaths, kratom has been identified in a number of overdose related deaths where one or more illicit drugs have also been present. In 2018, kratom was tied to a large number of salmonella outbreaks with many individuals hospitalized.

Like other substances with narcotic effects, kratom has the potential for abuse and dependence, which means that users may feel physical withdrawal symptoms when they stop taking it.

Withdrawal symptoms can include:

  • Muscle aches
  • Insomnia
  • Irritability
  • Hostility
  • Aggression
  • Emotional changes
  • Jerky movements
  • Runny nose

Mixing kratom with drugs can be dangerous, as they may have negative interactions with each other. Examples of substances that, when combined with kratom, can produce negative and sometimes life threatening effects include:

  • Prescription opiates (e.g., codeine, fentanyl, hydrocodone, methadone)
  • Stimulants (e.g., coffee, amphetamines, cocaine, yohimbine)
  • Depressants (e.g., alcohol, anti-anxiety medications, and anti-depressants)

The sale of products such as kratom, that are often sold for their narcotic-like effects, are in a category of drug at risk of being laced with opioids such as fentanyl or other dangerous substances for which a miniscule amount can be deadly.

What you should do

Speak to your doctor if you are considering taking kratom. Make sure that you are purchasing kratom from a safe source. If you are taking any other medications, consider how they could interact with kratom. You may also wish to consider licensed alternatives in place of kratom.

If you experience an adverse reaction using kratom, contact your health care practitioner right away. Consumers and health care practitioners are encouraged to notify Health Canada about adverse reactions through the MedEffect Web site.

Kratom is a substance that meets the definition of a drug under the Food and Drugs Act and is classified as a natural health product (NHP) in Canada in accordance with the Natural Health Product Regulations (NHPR). If a commercial importer wishes to import NHPs into Canada, they need to first apply for and be granted a site licence and product license(s) from the Natural and Non-prescription Health Products Directorate (NNHPD) of Health Canada. Authorized NHPs are issued a Natural Product Number (NPN) or a Homeopathic Medicine Number (DIN-HM), confirming their safety, efficacy and quality. As of the date of this notice, Health Canada has not authorized any products containing kratom for sale in Canada.

For more information, please refer to section 1.4 of the Site Licensing Guidance Document, available at the following link: https://www.canada.ca/en/health-canada/services/drugs-health-products/natural-non-prescription/legislation-guidelines/guidance-documents/site-licensing-guidance-document.html.

Health Canada's role

To minimize risks, Health Canada regulates health products to be sold to Canadian consumers through a rigorous licensing process, which includes an extensive pre-market review and ongoing post-market assessment of the health product's safety, effectiveness, and quality.

When Health Canada identifies unauthorized products that may pose serious health risks, Health Canada takes appropriate action to prevent further distribution and informs Canadians. This includes working with the Canada Border Services Agency to help prevent further importation of unauthorized products.

The following link provides information on a number of unauthorized products that may pose serious health risks to Canadians: http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2017/65132a-eng.php. Information is updated when Health Canada finds unauthorized health products that are falsely promoted and labelled to contain or have been tested and found to contain dangerous ingredients. A comprehensive list of recalls, advisories, and safety alerts for various health products can also be accessed through the Recalls and Safety Alerts Database.

The illegal sale or importation of unlicensed kratom products for sale in Canada is a violation of the Food and Drugs Act with a variety of compliance and enforcement actions available to Health Canada inspectors including:

  • Refused entry of the product at the border
  • Seizure of the goods and disposal at the cost of the person responsible for the shipment
  • Prosecution

For more information

For more information on the safe online purchase of health products, visit the following links:

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